Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
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Report on the global <strong>HIV</strong>/<strong>AIDS</strong> epidemic – June 2000personnel, but few countries have as yet fully understood the epidemic’s impact onhuman resources in their health sector. A study in Zambia showed that in one hospital,deaths in health care workers increased 13-fold over the 10-year period from1980 to 1990, largely because of <strong>HIV</strong>. As in other sectors of the economy, risingrates of <strong>HIV</strong> infection in health care workers will increase rates of absenteeism,reduce productivity, <strong>and</strong> lead to higher levels of spending <strong>for</strong> treatment, death benefits,additional staff recruitment <strong>and</strong> training of new health personnel.Impact on agricultureAgriculture is one of the most important sectors in many developing countries, particularlywhen measured by the percentage of <strong>people</strong> dependent on it <strong>for</strong> their <strong>living</strong>.Although the sector may produce only 20% of a country’s wealth (measured asa percentage of the gross national product), it might provide a <strong>living</strong> or survival <strong>for</strong>as much as 80% of the country’s population. Indirectly, it provides a livelihood <strong>for</strong>still other parts of the population, such as processing workers on sugar estates (see“The bottom line”, below).The effect of <strong>AIDS</strong> is devastating at family level. As an infected farmer becomesincreasingly ill, he <strong>and</strong> the family members looking after him spend less <strong>and</strong> lesstime working on his family’s crops. The family begins to lose income from unmarketedor incompletely tended cash crops, has to buy food it normally grows <strong>for</strong>itself, <strong>and</strong> may even have to sell off farm equipment or household goods to survive.The vicious circle is compounded by the high costs of health care, whether the sickperson turns to a traditional healer or to the health services. A 1997 study by theFood <strong>and</strong> Agriculture Organization of the United Nations (FAO) showed that in themid-west of Côte d’Ivoire, care <strong>for</strong> male <strong>AIDS</strong> patients cost on average aboutUS$ 300 a year, representing a quarter to a half of the net annual income of mostsmall-scale farms.The time lost by family members must also be taken into account. For instance, therepeated absence of another member of the farm to accompany the patient to ahealer also reduces the farm’s production. And when the most debilitating phasesof <strong>AIDS</strong> coincide <strong>with</strong> key farming periods such as sowing or clearing, the timespent nursing a sick person <strong>and</strong> lost to farm labour is sorely missed. A recent surveyin the rural Bukoba district of the United Republic of Tanzania found a radicalshift in the allocation of labour time: a woman <strong>with</strong> a sick husb<strong>and</strong> spent 60% lesstime on agricultural activities than she would normally do.Altogether, the effects on production can be serious. In West Africa, many caseshave been reported of reduced cultivation of cash crops or food products. Theseinclude market gardening in the provinces of Sanguié <strong>and</strong> Boulkiemdé in BurkinaFaso <strong>and</strong> cotton, coffee <strong>and</strong> cocoa plantations in parts of Côte d’Ivoire. A recentstudy in Namibia by the FAO concluded that the impact on livestock is considerable,<strong>with</strong> a heavy gender bias: households headed by women <strong>and</strong> children gener-32